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7 PLM5E NAY I- UM THIS iNVUii'E <br /> m Clstcow EPA#C-VA \t L! 1 <br /> - --5-- CAintofner EPA M��i(�i���- Date:,C"1( — 10 <br /> T Dh fiver EPA 9CAL 91:3534912 ,�Slta�le Manliest Document it giver EPA#G'AL 9' i 1 <br /> 35 312 State Manifest Document# <br /> W GHP#CA88940 ! � t,5� - CHP#GA81;9nu - <br /> W r f <br /> a 81 <br /> SACRAMENTO WA'STE OIL SACRAMENTO WASTE OIL <br /> 4504 aunnhlrry Way a Sacrarr*nto,CA 95842 <br /> (916) 849-©144 45o4 t�lnn X918)y849-a01 ito,GA 44 958-4? <br /> Transporters Registration No:3130 INVOICE NO. 21469 21130 <br /> _ Transporters Registration No:3130 INVOIG£NO. <br /> A <br /> W.NAME_ ; 1 ''AC-PHONE �o'I) I i� �G <br /> - r' CG.NAME i N i ?_ .u0 � PHONE <br /> �} [ ,•� - <br /> DRESS_O e �_-__�_,_ — !— �1 L e- �. f meq. <br /> r- ADDRE,75 5- 1%_4.._ i� -�-• <br /> td`�i _ "3 - { .\• SiA T ZIP C, Cl�1 !,fi-Y .. .._�de.K_ll - _ - --STATE ZIP <br /> Z QTY DESCRIPTION PRICE -- --TOTALt --- - 13ESCMPTION — PRICE TOTAL <br /> = Nan-RCRA Hazardous Waste Liquid <br /> - <br /> �- Non-RCRA Hazardous Waste Li ,yid <br /> ��� Gallons of used oil pumped out of �'a �- Gailons of used oil pumped oul of <br /> w drums or tank. - - -— - I / <br /> (221) ! drums or tank. {221}� ��- coal <br /> `I Nan-RCRA Hazardous Waste Liquid <br /> Gallons of used antifreeze pumped l Gallons of used anti-freeze pumped <br /> Non-RCRA Hazardous Waste taquid , /per <br /> out of drums 4r tank. 1343} 9 _ out of drums or tank- (343) gall <br /> Non-t;CRA.Hazardous Vgaste L'quid Non-RCRA Hazardous Waste Liquid <br /> Gations of oiiy water pumped Gallorc- of oily;eater pumped <br /> out of drums or tank' '223) out of drums or tank. (22 ) I <br /> m <br /> N t <br /> � r <br /> 9 <br /> DESTINATION OF OIL P.O. Service Charge <br /> 1515 S.River Road I J15 5.nriner ROad ---- --� <br /> West Sacr 3meflt ,CA tik5f39t NOTAL r Nest Sacramento.CA 95691 TOTAL <br /> v <br /> v <br />- When use vd the £n x estiv pfrr.=er#re.sacrairtentn waste 09 Services agrE s vdth the gaterahx <br /> V(11e0,15ivQ rhe axxsorirtated rnarrftesthr <br /> 3 Procedure.Sarxamento Waste oil 5envlces agrees with the gmerator <br /> Iisiod Wl:7w to hwe tr*p � e <br /> aneratrV&tardous waste irmVcrted' an authcried fvrxardous wasle treatme"t Iestotl NA.,-,4 to haves?he rfenerator*s hazardous wash:tra 4x r"to er,authorvPd ha7artfcus waste treaknenl <br /> facriity for apfxoprei3e tre4ent. fwflity for apprepdate,heetrna-n' <br /> Generator's Ceatication:t ceftrfY that 1 have a Nrcgarn in plar:e 4r reriuce 011 vt,lume_nrnl i(Jxu;ily ur wkm5f nicxne arxi toxicity::.w:35tB <br /> s Generator's Certifieat;on'I x:rti that I ave& n ptice.to re dw*,.tha� r <br /> ri generatE:i to the tlegrw i he nerd 1D --,n�rni%ally ctvable. <br /> 7ener to r T�the degree t tie +r eoono cally practicam. <br /> 4 Generator's S.9"atuee' <br /> GanefAmt}tY` <br /> --� - ------- --- — ------ --- 's Signature:t` _ <br /> N ----- - ---.�._._..___.._.. <br /> Corina PC[S�n: __ -. -.. _ i conlact <br /> _ t <br /> m Tjrdnspxjeeu 5r T.ransoorter's sionature �nion#i <br /> Terry nel 1r,dav�.hrvi lrAcharged295pet anxrth(24%pervaa0cnaooritstot paid witt»r30nays. Term not 7G da s Fwrdrxa. a of 2'K 446 er on arca rka rr#A S25.P0 Fee wifl be.,enaiped tot returned checks y t� PetCI P Y Paid wi#ttrr 30 days. <br /> A V5 00 Fee will be charged fur retw d checks. <br />